Venu Menon
Wellington, December 28,2023
Endometrial cancer cases are on the rise in New Zealand.
Endometrial cancer, which occurs in the lining of the uterus (womb), is marked by heavy or abnormal menstrual bleeding, according to a study published in the Australian and New Zealand Journal of Obstetrics and Gynaecology.
The study, titled ‘Increasing incidence of endometrial cancer in Aotearoa New Zealand: Health Professionals’ perspective,’ was conducted by the University of Otago, Wellington.
Co-author Dr Claire Henry, of the Department of Surgery and Anaesthesia, said endometrial cancer cases had spiked over the past decade in New Zealand, which formed part of a worldwide trend.
Changing landscape
“Historically, endometrial cancer occurred post-menopause, but the age landscape is changing. The incidence is now increasing before people reach menopause. There are many and complex reasons for this increase,” Dr Henry noted.
Researchers interviewed 15 healthcare professionals who had been caregivers to endometrial cancer patients.
Weight factor
The study quoted a participant as saying: “There is a huge amount of alarm among the oncology community about the rates, they are just rocketing up. Other cancer rates are staying the same or going down. But this is the outlier, and really linked to obesity.”
There was concern among participants over the “increasing number of people presenting each year with endometrial cancer who have high weight.”
The disease also impacted fertility.
“It’s terrible, as this is affecting younger and younger women…..some are needing to have hysterectomy before they’ve had their children,” said a study participant.
Hysterectomy was emerging as the standard treatment for endometrial cancer.
While cases were mounting, there was an alarming lack of awareness about the disease, accompanied by a shortage of staff as well.
Health inequities
More young women were being diagnosed with the disease, with an attendant concern around health equity.
“We are seeing more younger women than we were ….. in the under 45s, 47-48 % of them are Pacific,” a participant observed.
Dr Henry admitted the need for “more awareness and advocacy in this space.”
Inequities were pronounced in access and outcomes “which can occur over the care continuum,” researchers noted.
The need was to develop “equity-focused initiatives” to improve outcomes for those who were diagnosed with, or at risk of, endometrial cancer.
Healthcare professionals stressed the correlation between excess weight and the risk of developing the disease.
The study noted that of the 20 most common cancers, endometrial cancer had “the strongest association with high weight.”
The research used the term ‘high weight’ throughout in order to circumvent the “stigma and bias associated to individuals when labelled as obese or overweight.” The term ‘high weight’ indicated a body mass index [BMI] greater than 25 kg/m.
The likelihood of an individual with high weight developing endometrial cancer “increases significantly as additional excess weight accumulates,” the research found.
Treatment lagged behind on account of “workforce and equipment shortfalls.” This influenced “treatment options, health outcomes and survivorship,” researchers noted.
Conclusions
Researchers said action was required to address “incidence, awareness, access to equitable and inclusive treatment, and survivorship.”
All of these factors played a part in the 59% increase in endometrial cancer cases in New Zealand over the last ten years.
The cases had been increasing steadily for all ethnic groups, “with Pacific individuals having notably higher rates.”
Dr Henry has put the healthcare establishment on notice: “A call to action to address the rising incidence of endometrial cancer is overdue.”
Venu Menon is an Indian Newslink reporter based in Wellington
